Membership Application Form

Welcome to Pontypridd Roadents AC! Complete the form below to apply for membership. Once submitted, our membership secretary will be in touch with payment instructions.

If you'd prefer to apply by email, contact [email protected].

Don't fill this out:

Your details

First name *Last name *

Date of birth *GenderSelect...FemaleMaleNon-binaryPrefer not to say

Address *

Email *Telephone *

Emergency contact

First name *Last name *

Address *Telephone *

Membership type *

Annual membership runs from 1st April. Fees include Welsh Athletics affiliation where applicable.

Senior Membership (20+)£45Junior Membership (17–19)£352nd Claim / Associate£24

Affiliation

Are you affiliated with another club? *

Yes No

Club nameRegistration number

Health declaration

Do you have any health considerations we should know about? *

Yes No

Please provide details

Confirmations

I understand that participation in physical activity carries inherent risk and I take part at my own risk. * I have read and agree to abide by the Club Constitution, Code of Conduct, and Social Media Policy. * I consent to photographs taken at club events being used for club promotion (website, social media, press). I consent to my personal data being stored and used by Pontypridd Roadents AC and Welsh Athletics for membership administration. *